Abstract

Aims To evaluate the number of DNAs of both initial (IHA) and review health assessments (RHA), to identify any safeguarding or quality assurance issues within the LAC (Looked After Children) population and to ensure no group of LAC was disadvantaged in accessing health assessments.

Methods A retrospective audit covering April–August 2014 of all DNAs for IHAs and RHAs was undertaken. A re-audit for April–August 2015 was conducted. Data was gathered from paper and electronic records. An audit pro-forma was used to record information. The audit reviewed demographic details and activity data for all LAC who did not attend their health assessment.

Results The total rate of DNAs (IHAs and RHAs) was 6.5% (10/153) in the 2014 audit. This went down to 3.5% (6/168) in the 2015 period. The DNA rate for IHA was 1/56 (1.8%) in the 2015 period compared to 5/40 (12.5%) in the 2014 period. The number of DNAs remained the same for RHA (4.4%) in both audits (Figure 1). The age range of non-attenders was 13–17 years in the 2014 audit. The mean age was 16.8 years in the re-audit. The predominant ethnic group was White in both audits. CSE (child sexual exploitation) was a significant issue in the 2014 audit, leading to the hypothesis that non-attendance was associated with safeguarding issues. All young people not attending their health assessment were enrolled in an engagement pathway to ensure they were not lost to follow up. Risk factors associated with non-attendance are summarised in Table 1.

Conclusion The audit shows significant improvement in the overall DNA rate. The use of an engagement pathway to support choice and safeguard young people and the attendance of the social worker to all IHAs are likely to have contributed to the low DNA rate. DNA around time of leaving care suggests that transition planning for LAC needs to start at an earlier age and alternative methods need to be explored such as the use of multimedia for young people.

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